Dong Huan-Ji, Gerdle Björn, Dragioti Elena
Pain and Rehabilitation Centre, Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden.
J Pain Res. 2022 Aug 30;15:2557-2576. doi: 10.2147/JPR.S362913. eCollection 2022.
There is considerable diversity of outcome selections and methodologies for handling the multiple outcomes across all systematic reviews (SRs) of Interdisciplinary Pain Treatment (IPT) due to the complexity. This diversity presents difficulties for healthcare decision makers. Better recommendations about how to select outcomes in SRs (with or without meta-analysis) are needed to explicitly demonstrate the effectiveness of IPT.
This overview systematically collates the reported outcomes and measurements of IPT across published SRs and identifies the methodological characteristics. Additionally, we provide some suggestions on framing the selection of outcomes and on conducting SRs of IPT.
Three electronic databases (PubMed, Cochrane Library, and Epistemonikos) and the PROSPERO registry for ongoing SR were supplemented with hand-searching ending on 30 September 2021.
We included 18 SRs with data on 49007 people from 356 primary randomised controlled trials (RCTs); eight were followed by meta-analysis and ten used narrative syntheses of data. For all the SRs, pain was the most common reported outcome (72%), followed by disability/functional status (61%) and working status (61%). Psychological well-being and quality of life were also reported in half of the included SR (50%). The core outcome domains according to VAPAIN, IMMPACT, and PROMIS were seldom met. The methodological quality varied from critically low to moderate according to AMSTAR2. The AMSTAR2 rating was negatively correlated to the number of outcome domains in PROMIS, and VAPAIN was positively correlated with IMMPACT and PROMIS, indicating the intercorrelations between the reported outcomes.
This systematic overview showed wide-ranging disparity in reported outcomes and applied outcome domains in SRs evaluating IPT interventions for chronic pain conditions. The intercorrelations between the reported outcomes should be appropriately handled in future research. Some approaches are discussed as well.
由于跨学科疼痛治疗（IPT）的复杂性，在所有关于IPT的系统评价（SR）中，结果选择和处理多个结果的方法存在相当大的差异。这种多样性给医疗保健决策者带来了困难。需要就如何在SR（有或没有荟萃分析）中选择结果提供更好的建议，以明确证明IPT的有效性。
本综述系统整理了已发表的SR中报道的IPT结果和测量方法，并确定了方法学特征。此外，我们就IPT结果的选择框架和进行SR提供了一些建议。
通过检索三个电子数据库（PubMed、Cochrane图书馆和Epistemonikos）以及正在进行的SR的PROSPERO登记册，并于2021年9月30日结束手工检索。
我们纳入了18项SR，数据来自356项初级随机对照试验（RCT）中的49007人；其中8项随后进行了荟萃分析，10项采用了数据的叙述性综合分析。在所有SR中，疼痛是最常报道的结果（72%），其次是残疾/功能状态（61%）和工作状态（61%）。纳入的SR中有一半（50%）还报告了心理健康和生活质量。很少有研究满足VAPAIN、IMMPACT和PROMIS的核心结果领域。根据AMSTAR2，方法学质量从极低到中等不等。AMSTAR2评分与PROMIS中的结果领域数量呈负相关，VAPAIN与IMMPACT和PROMIS呈正相关，表明所报告结果之间存在相互关联。
本系统综述显示，在评估慢性疼痛状况的IPT干预措施的SR中，所报告的结果和应用的结果领域存在广泛差异。在未来的研究中应适当处理所报告结果之间的相互关联。还讨论了一些方法。
